• Background
  Pathology Associates Medical Laboratories operates the largest state-of-the-art, full-service reference laboratory in the northwestern U.S and is recognized as a national leader in hospital partnering and laboratory joint ventures.
• Challenge
  Link tests in real time to create a single, complete view of the patient.
• Solution
  Deploy Initiate software, with its accuracy and flexibility, to link electronic patient information across more than 100 hospitals and 7 million unique patients.
• Results
  A solid framework for linking patient test data in real time improved physician access to patient clinical history and supports ongoing applications development.

Pathology Associates Medical Laboratories (PAML), a state-of-the-art, full-service reference laboratory, is the largest independent laboratory in the northwestern United States. PAML provides a diverse range of testing services to over 100 hospitals throughout its core market and is recognized for maintaining high quality customer service through leveraging advanced technologies.

PAML wanted to increase the level of service they delivered to their clients and to sustain their leadership in the industry. To make this happen, they knew they needed to create a complete, on-demand clinical view of their patients by enabling their tests to be linked in real time. Successfully linking these patient tests would enable PAML to establish a comprehensive clinical history of each patient which would directly impact care efforts. Real-time linking would also improve the quality of results reporting, billing, and concurrently, bottom-line profitability. To achieve their business goals, PAML needed to find an Enterprise Master Patient Index (EMPI), a specialized form of master data management (MDM), that would help them provide a comprehensive set of advanced reference procedures to their 100+ client hospitals.

• Aggregate billing – Billing that links test data, including costs, for each patient. Receiving only one bill would provide value to patients while creating more efficient workflow and reduced expenses for the organization.
• Clinical outcomes – Outcomes with established chronological clinical histories would facilitate test comparisons. Labs and patient care providers could easily review the results of tests and changes over time for any given individual.

Furthermore, accurate linking of patient billing information would facilitate sending bills to the right individuals, resulting in additional savings to the organization.

PAML needed an EMPI that would transform their system from one where information is available for only one instance to a totally comprehensive solution where integrated data would be available in real-time. Also, the chosen EMPI software’s web capabilities needed to be consistent with their business objectives of improving physical access to patient data. It had to link with existing software and incorporate into PAML’s environment, easily and seamlessly.

Recognizing the complexity they were facing, PAML chose Initiate software because it could support the complete range of their strategic business objectives and deliver the accuracy and flexibility required in the complex health services environment. PAML also quickly recognized that their project would gain even greater value due to Initiate Systems’ core expertise in patient data integration and their superior understanding of the real-world issues surrounding their clients' data, which was particularly strong when compared to other vendors.

An accurate and flexible tool for linking patient information was a critical requirement to PAML when considering establishing a patient’s comprehensive clinical history. PAML does not have a lot of face-to-face patient interaction where additional information can be gathered, so selecting a vendor who had a flexible data model and real-time capabilities to facilitate the integration of patient information with sophisticated probabilistic algorithms would help minimize the ongoing costs of maintaining high levels of data quality.

To formulate a project plan, which consisted of five implementation stages, the Initiate Systems’ functional and technical project leaders worked closely with PAML’s project and development staff. Initiate Systems analyzed data from PAML’s two key sources of information, their billing system and affiliated hospital master patient indices. A test phase established linkages within each and across both of the sources. Both teams verified the linkages and Initiate Systems moved into full production stage.

Initiate Systems deployed the Initiate software and trained PAML’s staff on how to use their new EMPI. PAML is using their EMPI to establish linkages in real-time and apply those linkages to accomplish their goals of identifying patients to support results reporting and accurate billing. They are continuing to leverage the Initiate software by developing their own applications that will be used on top of this core application. Having the tools and knowledge for using the customer database file establishes a framework for completing additional internal development activity, including a CRM application.

PAML’s EMPI has become an environment of real-time data integration for its 100+ hospitals, advancing its mission of supplying enhanced services to clients and improving physician access to patient data. Today, Initiate software is helping support 7 million unique patients comprising 130 million linked records, with 36,000 transactions per day.

PAML has seen incredible results since implementing Initiate software. On the business end, Days Sales Outstanding (DSO) has dropped from 60 days to 35 as a result of better data quality. Each one day drop in DSO saves PAML $150,000 annually. Additionally, better data quality prevents an estimated 500 to 1,000 mail returns daily, saving an estimated $10,000 per month since Initiate software “remembers” bad addresses.

Most importantly, patients have benefited greatly. Patients now receive a consolidated bill reflecting all episodes of care, regardless of where the care was provided or which insurance provider is responsible. This helps patients better track deductibles, co-pays and other financial matters in a single statement. Additionally, since physicians, payers and public health authorities can view comprehensive, linked lab results from multiple doctors and hospitals, they can make comparisons and deliver higher quality, more cost-effective care.

PAML plans to build on the Initiate software and leverage its flexibility, increasing the number of data sources as their business grows. PAML is also moving beyond the current patient record integration to adding provider information via the Initiate software. The objective is one patient, one provider and one bill.